DILANTIN INFATABS Rx
Generic Name and Formulations:
Phenytoin 50mg; chewable tabs.
Indications for DILANTIN INFATABS:
Tonic-clonic, psychomotor and neurosurgically induced seizures.
May be chewed or swallowed whole. Initially 2 tabs 3 times daily. Maintenance dose: 6–8 tabs daily in divided doses; may increase to 12 tabs daily if necessary.
Initially 5mg/kg per day in 2–3 equally divided doses. Increase weekly if needed. Usual maintenance: 4–8mg/kg per day; max 300mg daily.
History of prior acute hepatotoxicity due to phenytoin. Concomitant delavirdine.
Suicidal tendencies (monitor). Diabetes. Discontinue if acute hepatotoxicity occurs; do not restart. Adjust dose gradually. Discontinue if first sign of rash develops. Monitor serum levels when switching between sodium salt of phenytoin (caps) and free acid form (suspension, Infatabs). Use proper dental hygiene. Hormonal contraception. Monitor bone mineral density with chronic use. Porphyria. Slow metabolizers. Renal and/or hepatic impairment. Hypoalbuminemia. Elderly. Debilitated. Pregnancy: avoid. Nursing mothers: not recommended.
Potentiated by acute alcohol ingestion, amiodarone, antiepileptic agents (eg, ethosuximide, felbamate, oxcarbazepine, methsuximide, topiramate), azoles (eg, fluconazole, ketoconazole, itraconazole, miconazole, voriconazole), benzodiazepines (eg, chlordiazepoxide, diazepam), capecitabine, chloramphenicol, disulfiram, estrogens, fluorouracil, fluoxetine, fluvastatin, fluvoxamine, halothane, H2-blockers (eg, cimetidine), isoniazid, methylphenidate, omeprazole, phenothiazines, salicylates, sertraline, succinamides (eg, ethosuximide), sulfonamides, ticlopidine, tolbutamide, trazodone, warfarin. Antagonized by anticancer drugs (eg, bleomycin, carboplatin, cisplatin, doxorubicin, methotrexate), chronic alcohol ingestion, carbamazepine, diazepam, folic acid, fosamprenavir, nelfinavir, reserpine, rifampin, ritonavir, St. John’s wort, sucralfate, theophylline, vigabatrin. Antagonizes albendazole, HIV antivirals (eg, efavirenz, lopinavir/ritonavir, indinavir, nelfinavir, ritonavir, saquinavir), antiepileptic agents (eg, carbamazepine, felbamate, lamotrigine, topiramate, oxcarbazepine, quetiapine), atorvastatin, fluvastatin, simvastatin, chlorpropamide, clozapine, cyclosporine, digoxin, folic acid, methadone, mexiletine, nifedipine, nimodipine, nisoldipine, praziquantel, verapamil. Reduces efficacy of concomitant azoles, corticosteroids, doxycycline, estrogens, furosemide, irinotecan, oral contraceptives, paclitaxel, paroxetine, quinidine, rifampin, sertraline, teniposide, theophylline, vitamin D, warfarin. Concomitant fosamprenavir/ritonavir may potentiate amprenavir. Concomitant neuromuscular blockers (eg, pancuronium, vecuronium, rocuronium, cisatracurium); may need higher infusion rate. Variable effects with phenobarbital, valproic acid, sodium valproate. Absorption decreased by calcium, antacids.
Nystagmus, ataxia, slurred speech, decreased coordination, somnolence, mental confusion, headaches, dizziness, cerebellar atrophy, nausea, vomiting, constipation, gingival hyperplasia, osteomalacia, blood dyscrasias, lymphadenopathy, cardiovascular events, hepatic disease, hyperglycemia, SLE, hypertrichosis, lab test abnormality; rare: rash (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis), DRESS, multiorgan hypersensitivity (may be fatal).
To enroll in the North American Antiepileptic Drug Pregnancy Registry call (888) 233-2334.
Caps 30mg—100; 100mg—100, 1000; Tabs—100; Susp—8oz
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